The German healthcare system spends 42 billion euros annually on administration. That is 12% of total healthcare expenditure. In Denmark, it is 4%.
The electronic health record (ePA) was approved in 2003. It was launched in 2025 — 22 years later. In that time, Estonia digitalized its entire healthcare system. Estonia has 1.3 million inhabitants and a GDP smaller than that of Hamburg.
During the COVID pandemic, public health offices reported infection numbers to the Robert Koch Institute by fax. This is not a joke. It is documented. By. Fax.
The Diagnosis
The German healthcare system is not hostile to technology. It is afraid of technology. Every digitalization effort fails due to the interplay of: data-privacy concerns, the physicians' lobby, insurance-fund interests, federal-state jurisdictional disputes, and the general conviction that things are "different here."
The result: a system that spends 42 billion on bureaucracy, cannot provide patients electronic access to their own medical records, and in which doctors dictate referral letters for a secretary to type up.
KIfD's Position
- Mandatory electronic health record for all. No opt-out option that undermines the entire infrastructure.
- Open, standardized interfaces (FHIR) for all health data.
- AI-powered diagnostic support as a mandatory component in emergency departments.
- Elimination of all fax machines in medical facilities by end of 2027. Those who fax, pay.
- Central research data registry for anonymized health data — with strict governance but full accessibility for accredited research.
A person lying in an ambulance in 2026 has a right to have the emergency physician know their allergies. Not because the patient has their card on them. But because the system knows.